| NPI | 1922341437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME135972) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 78166) |
| 207L00000X Anesthesiology (Licence: IN 01090934A) | |
| 207L00000X Anesthesiology (Licence: NY 282592) | |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2026-04-22 |